NPIMap

Organization Active NPI

Bruce K Burton MD PA

Doing business as Malvern Diagnostic Clinic

  • Clinic/Center
  • Malvern, AR
National Provider Identifier
1376639344
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MC 0784 Issued in AR
Legal business name
BRUCE K BURTON MD PA
Doing business as
Malvern Diagnostic Clinic
Practice address
2223 Grant Street
Malvern, AR 72104
Phone
(501) 337-9031
Fax
(501) 337-9033
NPI assigned
Oct 5, 2006
Last updated
Nov 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bruce Kent Burton, MDNPI 1952497240
Title
President Owner
Phone
(501) 337-9031

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MC 0784 AR Primary

Addresses

Primary practice location

2223 Grant Street
Malvern, AR 72104

Mailing address

2223 Grant Street
Malvern, AR 72104
Phone (501) 337-9031

Other identifiers 2

IdentifierTypeStateIssuer
110030002MedicaidAR
57801OtherARBCBS

Other names 1

  • Malvern Diagnostic Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1376639344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 GRANT STREET",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "72104",
            "telephone_number": "501-337-9031",
            "fax_number": "501-337-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 GRANT STREET",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "72104",
            "telephone_number": "501-337-9031",
            "fax_number": "501-337-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE K BURTON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT    OWNER",
        "authorized_official_telephone_number": "501-337-9031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": "MC 0784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110030002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "57801",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malvern Diagnostic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Malvern, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.